MUAs and MUPs are designated based on a project community's or project population's score on an "Index of Medical Underservice."

The score required for designation is 62 out of 100 points. A "zero-score" represents a community totally lacking in medical services, while communities with a 100-score have very good primary care services with no apparent deficiencies. The Health Resources and Service Administration (HRSA) bases its index on composite scores from the following categories:

o The percentage of the project population that is below the Federal Poverty Level

To make a project's conclusions valid, a proposed designation needs to have defined boundaries in order to show government officials how a community is entitled to a shortage designation.

This process is called 'defining a service area.' HPSA Acumen has done this for most of the 200-plus shortage designations we've completed in the past 15 years. It requires skill and experience to do it well and consistently. It involves a review of area topographic, population density and road maps overlaid with demographic information as well as data provided by clients.

Once HPSA Acumen has worked with the client and the government to define an appropriate service area, Acumen researchers collect project data from the most accurate statistics available from the U.S. Census Bureau and states' health departments.

The final key component of the analysis (and one in which HPSA Acumen is nearly unique) is gathering information on physicians.

HRSA requires all information on physicians to show how many full-time equivalents or FTEs those physicians produce every week and how the FTEs fulfill, or fail to fulfill, the needs of the project community. HPSA Acumen staff research every potential physician in a community and fully survey only those who are or likely to be primary care providers – efficiently gathering information in the most precise manner possible.

Once the research is complete, HPSA Acumen executives submit their findings to the clients as well as the state and federal governments for consideration. Executives monitor the submission's progress and stay on top of any issues government officials may raise on a project – guiding the MUA or MUP project to a complete and successful conclusion.